2021
DOI: 10.1016/j.ebr.2021.100457
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Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy

Abstract: Highlights Seizures have been observed in epilepsy patients receiving high dose intravenous or intrathecal Methotrexate (Mtx) therapy for the treatment of leukemias, due to reduction in valproic acid (VPA) levels. Prolonged low dose weekly Mtx exposure can also produce reduction in VPA levels causing seizure relapse as reported in this case. Mtx competes with VPA for binding to albumin as a result of which a larger proportion of VPA become unbound and is r… Show more

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